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Utah rates for HCPCS J0895

Injection, deferoxamine mesylate, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $8.91 / $8.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $7.94 / $8.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.55 / $11.75 / $13.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $8.51 / $8.51
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $8.91 / $10.72
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $8.91 / $10.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $8.51 / $8.51